TYPE II DIABETES MELLITUS

Introduction: Diabetes Mellitus is a syndrome with disordered metabolismand inappropriate hyperglycemia due to either deficiency of insulin secretion or combinationof insulin resistance and inadequate insulin. Infections constitute the main bulk of cutaneousmanifestations of diabetes mellitus with incidence ranging between 20–50%. Bacteria andfungi can cause infective complications involving skin and nails of the diabetic patients. Themajor share of infections in Diabetes Mellitus is contributed by bacteria. The most commoncausative organisms are Staphylococcus aurous and beta-hemolytic Streptococci. Objective:to determine the frequency of cutaneousbacterial Infections in patients with type II DiabetesMellitis, attending outpatient clinic in a tertiary care hospital. Study Design: Cross sectionalstudy. Setting: Department of Dermatology and Medicine, Dr. Ziauddin University Hospital,KDLB Campus, Karachi. Period: 1st January 2017 till 31st March 2017 over a period of threemonths. Material and methods: Adult patients already diagnosed to be suffering from type 2Diabetes Mellitis presenting with cutaneous manifestations were included in the study. Patientsfulfilling the selection criteria were enrolled after an informed consent. Relevant laboratoryinvestigations were advised where required. Current study targeted bacterial infections onlyand Chi-square test was used to determine P value. Data obtained was compiled, tabulatedand analyzed by SPSS. Result: Total of 302 cases of Type 2 Diabetes Mellitis having somecutaneous manifestations were enrolled. There were 124 (41%) males and 178 (59%) females.Mean age of presentation was 50 ± 11 years, the age range being 30-80 years. The meanduration of diabetes was 8.5 ± 7 years (range being 1-30 years). Unsatisfactory glycemic controlwas present in 205 (68%) patients. Among the enrolled subjects bacterial infections were themost frequently seen skin disease accounting for 79 patients (26%). Among the patients withthese bacterial infections uncontrolled Diabetes was a feature in 61 (77%). The breakup ofbacterial infections (59) in the descending order of frequency stood as follows: cellulitis 22(28%), carbuncle 17 (21%), furuncle 14 (18%), ecthyma 13 (16%), folliculitis 09 (12%), andimpetigo 04 (5%). Conclusion: Cutaneous infections are a common feature in patients withType II Diabetes Mellitis, bacterial infections being the most common.

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Cutaneous manifestations of diabetes mellitus: a clinical study

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20183157 ◽

2018 ◽

Vol 4 (3) ◽

pp. 352

Author(s):

Nancy Bhardwaj ◽

Samarjit Roy ◽

Rashmi Jindal ◽

Sohaib Ahmad

Keyword(s):

Diabetes Mellitus ◽

Bacterial Infections ◽

Fungal Infections ◽

Tertiary Care ◽

Diabetic Control ◽

Diabetic Patients ◽

Tertiary Care Centre ◽

Cutaneous Manifestations ◽

Female Ratio ◽

Cutaneous Infections

Background: Diabetes mellitus is a leading cause of morbidity with adverse effects on various systems including skin. Cutaneous manifestations seen in diabetes aid in its diagnosis and some of them may also correlate with diabetic control, duration and other complications. This study was undertaken to estimate burden of skin disorders among diabetics in a tertiary care centre of Uttarakhand.Methods: The study was conducted at Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India, over a period of one year from January 2016 to December 2016. Three hundred and seventy seven patients irrespective of age and sex were included in the study and those with gestational diabetes were excluded. Patients were examined for mucocutaneous manifestations and evaluated. Structured case reporting form was used to generate data.Results: Out of 377 patients studies, 114 (30.2%) were in the age group of 51-60 years. Male to female ratio was 1.44:1. Mucocutaneous manifestations were present in 278/377 (73.7%) patients. Common cutaneous manifestations were cutaneous infections [fungal infections (n=106/377; 28.1%), bacterial infections (n=33/377; 8.8%)], pruritus (n=47/377; 12.5%), xerosis (n=39/377; 10.3%), diabetic dermopathy (n=36/377; 9.5%) and diabetic ulcers (n=24/377; 6.4%). Uncommon manifestations were necrobiosis lipoidica diabeticorum, alopecia areata, scleredema diabeticorum and granuloma annulare. Cutaneous reactions due to treatment of diabetes were noted in 4 (1%) patients.Conclusions: As prevalence of cutaneous manifestations is high in diabetic patients, knowledge of these will help in a timely and comprehensive management of both diabetes and dermatoses.

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EFFECT OF ORAL AZITHROMYCIN AND METRONIDAZOLE AS AN ADJUNCT TO SCALING AND ROOT PLANING ON GLYCEMIC CONTROL IN TYPE II DIABETIC PATIENTS WITH CHRONIC PERIODONTITIS

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i3.16500 ◽

2017 ◽

Vol 10 (3) ◽

pp. 449

Author(s):

Dhivya K ◽

Yogarajan K ◽

Shanmugarajan T S

Keyword(s):

Diabetes Mellitus ◽

Glycemic Control ◽

Chronic Periodontitis ◽

Alveolar Bone ◽

Tertiary Care ◽

Periodontal Therapy ◽

Diabetic Patients ◽

Care Hospital ◽

Type Ii ◽

Oral Azithromycin

ABSTRACTObjective: Periodontitis, a chronic inflammatory disease characterized by destruction of the periodontal ligament and alveolar bone is the sixthcomplication of diabetes mellitus. Periodontal treatment that reduces gingival inflammation aids in the control of hyperglycemia. Therefore, thepresent study was designed to determine the effect of treating chronic periodontitis with oral antibiotics azithromycin and metronidazole on the levelof serum glycated hemoglobin in type-II diabetic patients.Methods: This prospective observational study was carried out in the dental department of a tertiary care hospital for 9 months. Clinical andbiochemistry reports of 90 patients were collected in designed case report forms. All statistical analyses were performed using IBM Statistical Packagefor Social Sciences 17 and Graph Pad Prism 7.0.Results: Significant reduction in all the clinical and dental parameters was comparatively higher in patients who received azithromycin than inpatients who received metronidazole and scaling and root planning alone.Conclusion: Periodontal therapy with oral azithromycin can be employed as a supportive strategy for the management of diabetes mellitus.Henceforth, prevention and control of periodontal disease along with antibiotics must be considered an integral part of glycemic control. However,due to the lesser sample size in this study, further investigations are required to confirm the effect of periodontal therapy on systemic diseases.Keywords: Periodontitis, Azithromycin, Metronidazole, Glycemic control, Diabetes mellitus.

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ASSESSMENT OF MEDICATION EFFICACY ON DETERMINANTS OF PSYCHIATRIC ILLNESS AMONG DIABETES MELLITUS PARTICIPANTS

Journal of Biomedical and Pharmaceutical Research ◽

10.32553/jbpr.v8i3.597 ◽

2019 ◽

Vol 8 (3) ◽

Author(s):

Akza K Alex ◽

Bharathi DR ◽

Nataraj GR ◽

Adarsh Mathew ◽

Tejaswini SM

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Psychiatric Illness ◽

Tertiary Care ◽

Research Centre ◽

P Value ◽

Diabetic Patients ◽

Care Hospital ◽

College Hospital ◽

Determinant Factors

Introduction: The prevalence of Diabetes Mellitus (DM) among adults has been increased considerably across the globe, and has contributed a substantial proportion in annual mortality rate. Diabetes and psychiatric disorders are having such an interface that they both influence each other in several ways. Objectives: The study was conducted to assess the prevalence, determinant factors, prescription pattern, efficacy and adverse reactions in diabetic patients associated with psychiatric illness in a tertiary care hospital. Materials and Methods: A prospective observational study was carried out for a period of ten months in General Medicine and Psychiatric Department, Basaveswara Medical College Hospital and Research centre, Chitradurga. Results: In this study, a total of 101 diabetic patients with or without co-morbidities were enrolled in the study. Among them, 27 in-patients were associated with psychiatric illness which was considered as co-morbid condition. The prevalence of psychiatric illness with diabetes mellitus was found to be 26.7% which is highly significant with the p-value (0.00). A higher prevalence was noticed with age group 41-50 years and with male gender. The common determinant factors of psychiatric illness in diabetic patients were being women, having no income, being at the age of menopause, having no physical activity, being illiterate and being single or widowed. Among the anti-diabetic drug prescriptions, there was a higher percentage of use of insulin and the most commonly prescribed drug was combination of Glimepride + Metformin (sulfonylurea and biguanide). The most commonly prescribed anti-psychotic drugs were chlordiazepoxide and alprazolam. Conclusion: The study reveals a high prevalence of psychiatric illness in diabetic patients with determinant factors of psychiatric illness in diabetic patients were being women, having no income, being at the age of menopause, having no physical activity, being illiterate and being single or widowed. Key Words: Prevalence; Determinant factors; Diabetes mellitus; Psychiatric illness

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Study of Serum Electrolytes in Type 2 Diabetes Mellitus Individuals in Rural Tertiary Care Hospital in Kancheepuram District

Biomedical & Pharmacology Journal ◽

10.13005/bpj/2171 ◽

2021 ◽

Vol 14 (02) ◽

pp. 691-694

Author(s):

V. Santhosh ◽

D M. Gomathi ◽

A. Khadeja Bi ◽

S. Suganya ◽

G. Gurulakshmi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Type Ii ◽

Serum Electrolytes ◽

Intracellular Space

Aim: To measure the levels of Serum electrolytes (Na+, K+ ,Cl )in type II DM individuals and to compare it with healthy controls. Methods: A case control study was conducted at Medicine Department, from March 2019 to September 2019. A total of 60 patients ,comprised of 30 confirmed type II DM patients as cases and 30 healthy individuals of similar criteria were treated as controls. In both the groups,biochemical measurement of Serum electrolytes (Na+, K+ ,Cl ),FBS was studied and the results were compared. Results: Inindividuals with Diabetes mellitus sodium and chloride showed insignificant alterations.There was an increase in serum potassium levels which was found to be statistically highly significant (p-value less than or equal to 0.05) . The drift of potassium from intracellular space to extracellular space leads to Hyperkalaemia which is due torenal impairment, insulin deficiency or hypertonicity. Conclusion: This study concludes that there is significant association of potassium with hyperglycemic crisis in patients with type 2 diabetes mellitus. Thus serum electrolytes has to be routinely monitored in diabetic individuals since electrolyte derangements are markedly found in uncontrolled diabetes.

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A Study of Cardiac Autonomic Neuropathy among Type-II Diabetic Patients

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i41a32334 ◽

2021 ◽

pp. 345-352

Author(s):

B.V. Surendra ◽

N. S. Muthiah ◽

M. V. Sailaja ◽

K. Prabhu

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Autonomic Neuropathy ◽

Tertiary Care ◽

Male Gender ◽

Cardiac Autonomic Neuropathy ◽

Diabetic Patients ◽

Care Hospital ◽

Type Ii ◽

Duration Of Diabetes

Background: Though very common, CAN is a least understood complication of diabetes which is often under diagnosed. In diabetes mellitus patients, CAN leads to silent myocardial infarction and sudden death. So by identifying CAN early, which is asymptomatic will help to delay or arrest its progression. AIM: To find out the prevalence and the associated risk factors of Cardiac autonomic neuropathy (CAN) among type-II Diabetes Mellitus patients in a tertiary care hospital. Materials & Methods: A total of 273 type-II diabetic participants were selected after taking into consideration of inclusion & exclusion criteria. The prevalence of CAN was assessed by ewings and clarkesnon invasive cardiac autonomic neuropathy reflex tests. The association of risk factors with the presence of CAN was analysed by using Pearson’s chi square test. Data were analysed by using SPSS 16. The accepted level of significance was set below 0.05 (P<0.05). Results: The prevalence of CAN among type-II diabetic patients in this study was found to be 34%. Prevalence of CAN increased in the participants with male gender, increased age, and increased BMI, increased duration of diabetes, poor glycaemic control,dyslipidimea, smokers and hypertension and it is statistically significant. Conclusion: In this study it is observed that the prevalence of CAN increased with old age, male gender, poor glycemic control, increased duration of diabetes, Dyslipidemia, higher BMI, Hypertension & smoking. So risk factors associated with the CAN be detected and treated at an early stage to further reduce morbidity and mortality.

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An assessment of depression in type-II diabetics presenting at tertiary care hospital

10.53350/pjmhs211582093 ◽

2021 ◽

Vol 15 (8) ◽

pp. 2093-2095

Author(s):

Mahwish Adnan ◽

Ghulam Hassan ◽

Muhammad Abdul Raziq

Keyword(s):

Diabetes Mellitus ◽

Behavioral Science ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

P Value ◽

Care Hospital ◽

Type Ii ◽

Cross Sectional ◽

Duration Of Diabetes ◽

Type Ii Diabetics

Objective: To assess the frequency of depression in type-II diabetics presenting at tertiary care hospital. Materials & Methods: This cross sectional study was conducted at Department of Psychiatry & Behavioral Science, Sheikh Zayed Hospital, Rahim Yar Khan from April 2020 to October 2020 over the period of 6 months. Total 200 type-II diabetics having age 20-65 years either male or female were selected for this study. Depression was assessed in selected by using DSM-IV criteria for Depression. Results: Mean age was 54.37 ± 5.88 years. Out of 200 patients of diabetes, depression was noted in 46 (23%) patients. Most (98,49%) of the patients were between 51-65 years but difference of depression with age group was not statistically significant with p value 0.8958. Total 19 (20.88%) male patients and 27 (24.77%) female patients were found with depression. But depression was insignificantly associated with gender with p value 0.6315. Total 11 (14.29%) patients found with depression having duration of diabetes mellitus ≤3 years and 35 (28.46%) patients found with depression having duration of diabetes mellitus >3 years. Depression was significantly associated with duration of diabetes mellitus with p value 0.032. Conclusion: Our study concluded that prevalence of depression in type 2 diabetes mellitus patients was much higher and have shown positive association with extremes of ages and duration of disease. Keywords: Diabetes mellitus, depression, socioeconomic status, physical recovery

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A clinical study of diabetic dermatological manifestations at a tertiary care hospital in South India

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20182943 ◽

2018 ◽

Vol 4 (3) ◽

pp. 293

Author(s):

Vani G. ◽

L. Venkat Narsimha Reddy

Keyword(s):

Bacterial Infections ◽

Fungal Infections ◽

Tertiary Care ◽

Skin Lesions ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Care Hospital ◽

Cross Sectional ◽

Cutaneous Infections ◽

One Year

Background: The data on studies like lesions of the skin due to diabetes are scarce. Hence there is a need to conduct more studies on this topic of importance. The objective of the study was to study diabetic dermatological manifestations.Methods: A hospital based cross sectional study was carried out among 100 randomly selected patients during the study period of one year who were having diabetes as well as skin lesions due to diabetes. All diabetic patients were screened for presence of skin lesions. They were further differentiated based on the diagnosis.Results: Out of 73 patients having cutaneous infections 71.2% were having fungal infections. Out of 18 having bacterial infections 38.9% were having furuncles. Out of 52 having fungal infections 63.5% were having dermatophytosis. Out of 14 cases of candidal infections, the most common was intertrigo in 35.7%. Out of 33 cases of dermatophytosis, T. cruris was the most common in 54.5%. Out of 82 patients in whom we suspected dermatoses strongly associated with diabetes the most common condition was pruritus in 36.6% of the cases.Conclusions: Bacterial skin infections and dermatophytosis were the most common diabetic dermatological lesions in the present study.

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An Assessment of Retinopathy in Type-II Diabetics along with Microalbuminuria

10.53350/pjmhs211571749 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1749-1751

Author(s):

Muhammad Zafar Iqbal ◽

Muhammad Khalid ◽

Muhammad Haroon Bilal

Keyword(s):

Diabetes Mellitus ◽

Tertiary Care ◽

Type Ii Diabetes Mellitus ◽

P Value ◽

Care Hospital ◽

Type Ii ◽

Diabetes Mellitus Type Ii ◽

Number Of Patients ◽

Type Ii Diabetics ◽

Study Population

Objective: To assessment of retinopathy in type-II diabetics along with microalbuminuria at tertiary care hospital. Material and methods: This study was done at Department of Medicine, D.G Khan Hospital, D.G Khan from April 2020 to October 2020 over the period 6 months. Total 295 patients of type-II diabetes mellitus along with microalbuminuria having age between 45-80 years either male or female were selected. Diabetic retinopathy was evaluated in selected patients. Results: Total 295 patients were selected according to inclusion criteria. The mean age of patients was 58.13 ± 9.412 years. Out of 295 patients, retinopathy was noted in 67 (23%) patients. Out of 147 (49.83%) male patients, retinopathy was noted in 39 (26.5%) patients. Out of 148 (50.17%) female patients, retinopathy was noted in 28 (18.9%) patients. Statistically insignificant association of retinopathy with gender was noted with p value 0.119. Conclusion: Findings of this study showed a higher percentage of retinopathy in patients of type-II diabeties along with microalbuminuria. Most of the victims were males as compared to females and no association of development of retinopathy with gender was detected. Higher number of patients belonged to 4th and 5th decade of life. Four to five years of duration was noted among the half of the study population. Keywords: Retinopathy, Diabetes mellitus type II, Microalbuminauria

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Compliance of checking HbA1c in a tertiary care hospital of Pakistan

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.1.2814 ◽

2020 ◽

Vol 37 (1) ◽

Author(s):

Abdul Aziz ◽

Syed Ahsan Ali

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

University Hospital ◽

Diabetic Patients ◽

Care Hospital ◽

Creative Commons ◽

Glucose Levels ◽

Uncontrolled Diabetes

Background and Objectives: The prevalence of diabetes mellitus worldwide was 171 million one and half decade ago, while the prediction is 366 million patients by 2030 and more than 640 million people by 2040. HbA1c value represents average blood glucose over the past 2-3 months and accounts for both pre-prandial and post-prandial blood glucose levels. A link between HbA1c and diabetic complications has been confirmed. In general, patients with controlled diabetes mellitus should have at least biannual testing, while patients with uncontrolled diabetes mellitus or unmet glycemic targets should be tested every three months. The objective was to see compliance of checking HbA1c in tertiary care hospital of a developing world. Methods: This was a retrospective observational study done from 1st February 2019 to 31st March 2019 in the Department of Medicine and Surgery, The Aga Khan University Hospital, Karachi. All patients of age 18 years and above, admitted with a diagnosis of diabetes mellitus (DM) from 1st February 2019 to 31st March 2019 were included. If HbA1c was less than 7% the patients were labelled as having controlled DM, otherwise, uncontrolled DM. If HbA1c of patients with controlled DM was not checked in last six months and if HbA1c of patients with uncontrolled DM was not checked in last three months then it was labelled as non-compliance of checking HbA1c. Results: Out of 1732 diabetic patients only 94 patients fulfilled inclusion criteria. Out of these 94 patients 43 (45.7%) were male. Mean HbA1c was 7.90% (1.4) and 69 (73.4%) patients had uncontrolled diabetes mellitus. Overall, the compliance of checking HbA1c was 58.5%. In uncontrolled diabetes mellitus patients, the compliance of checking HbA1c was 45% and in controlled diabetes mellitus patients the compliance was 96%. Conclusion: The compliance of checking HbA1c is inadequate in diabetic inpatients. The considerable prevalence of diabetes and the benefits of timely interventions in diagnosed patients to prevent complications suggest the need for a comprehensive awareness among the doctors for checking HbA1c. doi: https://doi.org/10.12669/pjms.37.1.2814 How to cite this:Aziz A, Ali SA. Compliance of checking HbA1c in a tertiary care hospital of Pakistan. Pak J Med Sci. 2021;37(1):142-145. doi: https://doi.org/10.12669/pjms.37.1.2814 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Different patterns of cutaneous manifestation of diabetes mellitus type-2 observed in tertiary care centre of South West Rajasthan

IP Indian Journal of Clinical and Experimental Dermatology ◽

10.18231/j.ijced.2021.064 ◽

2021 ◽

Vol 7 (4) ◽

pp. 341-346

Author(s):

Kalpana Gupta ◽

Anurag Bareth ◽

Charul Agrawal

Keyword(s):

Diabetes Mellitus ◽

Diabetes Mellitus Type 2 ◽

Bacterial Infections ◽

Acanthosis Nigricans ◽

Statistical Tests ◽

Tertiary Care ◽

Diabetes Mellitus Type ◽

P Value ◽

Cutaneous Manifestations

Diabetes mellitus (DM) is a common endocrinal disorder caused by complex interaction of genetics and environmental factors. Various dermatological features are known to be cutaneous markers of diabetes mellitus like diabetic dermatopathy, acrochordons, acanthosis nigricans and bullous diabeticorum, etc. An observational cross-sectional study on a total of 400 patients of Diabetes Mellitus Type-2. A complete cutaneous examination was done in all cases to observe for the presence of any specific or nonspecific dermatosis. All the statistical tests were two sided and P-value <0.05 was considered as significant level. This study showed that in specific cutaneous disorders, Acrochordon 138(34.5%) was the most common manifestation which was followed by, Bacterial Infections 93(23.5%), Dermatophytosis 77(19.2%), Candidiasis 76(19%), Acanthosis nigricans 50(12.5%) and Onychomycosis 33(8.25%) in decreasing order. Xerosis 259(64.7%) was the commonest manifestation in non-specific cutaneous disorders followed by, Generalized pruritus 200(50%), Seborrheic keratosis 35(8.75%) in decreasing order. Cutaneous manifestations are quite common in uncontrolled (HbA1c>7gm) type 2 diabetes mellitus as compare to controlled group. Uncontrolled group is more prone to develop diabetic complication like hypertension, diabetic retinopathy and peripheral neuropathy etc. It is concluded that, Diabetes mellitus Type-2 involves the skin quite often and whenever patients present with multiple skin manifestation and then diabetic statusshould be checked and controlled.

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